Toward Emergency Department Preparedness: One Step at a Time

Abstract

In 1993, the Institute of Medicine published a report on the state of emergency medical services across the nation and found that systems for the care of children were often fragmented and unable to meet the needs of children and thus recommended that all emergency departments (EDs) be prepared to provide pediatric emergency care [1]. These recommendations led to a critical appraisal of existing resources and ways to improve the quality of pediatric care in EDs. A subsequent study reported that the equipment necessary to provide optimal care was frequently unavailable in many EDs and that this problem was particularly more frequent in smaller lower pediatric volume EDs [2]. The results of a survey conducted around the same time by the Society for Academic Emergency Medicine suggested that emergency medicine residents' exposure to newborn resuscitation and care was limited and therefore merited further attention during pediatric emergency medicine training [3]. In response to these concerns, the American College of Emergency Physicians and the American Academy of Pediatrics published a policy statement in 2001 on the guidelines for preparedness of EDs that care for children [4]. The Society for Academic Emergency Medicine subsequently published a position statement in 2003 stating that physicians certified in emergency medicine possess the knowledge and skills required to provide quality emergency medical care to children [5]. However, in a more recent report released in 2006, the Institute of Medicine again identified pediatric emergency services as an area requiring special attention, noting that the level of emergency pediatric care throughout the nation was “uneven”, and recommended that every pediatric and emergency care–related health professional credentialing